ASSESSMENT PRACTICES OF SPEECH AND LANGUAGE PATHOLOGISTS FOR COGNITIVE COMMUNICATION IMPAIRMENT AFTER TRAUMATIC BRAIN INJURY

Background of the Study: The aim of the present research was to examine the assessment practices of Speech-Language Pathologists for Cognitive Communication Disorders after Traumatic Brain Injury. Methodology: It was a cross-sectional survey method, a convenient sampling technique. Research was carried out from January 2021 to June 2021. The sample size was n=21, out of which n= 9 (42.8%) participants, each from Rawalpindi and Islamabad n= 3 (14.4%) participants from Lahore filled in their responses. Medium; being Online, the questionnaire was distributed either through email, WhatsApp or Facebook MessengerApp. SLPs who were undergraduates or who had no experience working with TBI clients were excluded. Questionnaire included 12 items. Responses of research participants were recorded using Google Forms and presented in the form of n (%). The data were analyzed using descriptive analysis, and chi-square analysis was performed to confirm the association between settings, city of practice and years of experience through Statistical Package of Social Sciences (SPSS) Version 22.0. Results: Speech-Language Pathologists reported that they routinely assessed (62% each) Receptive and Expressive communication. However; less than half of the participants routinely evaluated domains like verbal pragmatic skills (43.3%), functional communication (33.3%) and phonemic awareness (33.3%). SLPs assessed their clients by employing tests like MoCA (55.62%), Quick Aphasia Battery (18.75%), Cognitive Assessment (LOTCA Protocol) (14.35%) and a combination of Formal (48%) and Informal (52%) clinical interviews. Conclusion: Informal discourse assessment is incorporated more frequently as compared to informal discourse evaluation in assessment practices of Speech-Language pathologists of Pakistan for cognitive communication impairment followed by traumatic brain injury.

Advancements in Interstitial Brachytherapy

In recent years, interstitial brachytherapy implantation has become the treatment of choice for early stage prostate cancer patients. The popularity of this modality is due to the fact that five-and ten-year disease control rates using brachytherapy are equal to those of surgery, whereas, the toxicity and side-effects are perceived to be lower. Recently, a true linear source model RadioCoilTM103Pd has been introduced to overcome the shortcomings of traditional ―seed‖ type interstitial prostate brachytherapy implants, such as migration and clumping of the seeds. However, the existing prostate treatment planning systems and TG-43U1 have not been updated to perform dose calculation and parameterization respectively, for implant with linear sources greater than 1.0cm in length. Due to these limitations, the innovative design of RadioCoilTM103Pd could not be fully implemented for clinical applications. In this research, treatment planning aspect of elongated RadioCoilTM103Pd sources is investigated. In addition, accuracy of existing TG-43U1 recommended dosimetric parameters in polar coordinate systems, a modification in radial increment to improve the accuracy and modification of TG-43U1 parameterization in to cylindrical coordinate systems is also investigated. This work resulted in a calculational method and modification in TG-43U1 parameters for accurate dose calculation around elongated sources. Experimental, Thermolumenance Dosimetry TLD and Monte Carlo simulation techniques were employed in this investigation. This work was successfully completed and led to a new Task Group, TG-143 from American Association of Medical Phyicists in Medicine, AAPM, to provide guidelines for clinical application of elongated sources and extend our findings for other elongated sources.